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Drugs in the management of Glaucoma Flashcards

1
Q

_____ is the precursor for all sex hormones

A

cholesterol

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2
Q

how are androgens converted to oestrogen?

A

via aromatase enzyme

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3
Q

TF: progesterone levels in men are the same as in women

A

true

but not when women have ovulated as levels rise

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4
Q

oestrogen and progesterone are important in ______ in males

A

spermatogenesis

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5
Q

where is sperm produced?

A

testes

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6
Q

what are the 3 accessory glands in the male?

A

prostate
seminal vesicles
bulbourethral glands

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7
Q

what do the 3 accessory glands to do to the ejaculate?

A

secrete fluid into it

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8
Q

what passes through the urethra?

A

both urine and semen

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9
Q

why does both urine and semen pass through the urethra?

A

as the vas deferent feed the urethra below the bladder

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10
Q

what glands secretions line the male tract and make it lubricated for sperm flow

A

Bulbouretheral gland

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11
Q

what fills with blood when a male has an erection?

A

the croups cavernous and the

spongiosum

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12
Q

function of the testis

A

sperm production

steroid hormone production

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13
Q

function of the epididymis

A

sperm collection and maturation

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14
Q

function of the ductus deferens

A

transport and storage

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15
Q

functions of the urethra

A

transport

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16
Q

what part of the testes produces sperm?

A

seminiferous tubules

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17
Q

what happens to the sperm once its produced by the seminiferous tubules?

A

passes through tubes into the efferent ducts and then into the epididymis for maturation

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18
Q

2 cells in the seminiferous tubules?

A

larger and smaller cells

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19
Q

characteristics of the larger cells in the seminiferous tubules?

A

resident epithelial cells of the tubules

provide environment for sperm development- nurse cells

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20
Q

characteristics of the smaller cells in the seminiferous tubules?

A

more concentrated towards the centre of the tubule (with smaller nuclei- characteristic of developing sperm) the spermatozoa are moving from inside the tubule, upwards through the nurse cell environment and concentrate near the top side of the inner surface of the Sertoli cell. Then put into the lumen of the tubule and transported.

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21
Q

seminiferous tubules are surrounded by _____ _____

A

myoid cells

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22
Q

the spaces between the tubules contain _____ cells

A

leydig- interstitial

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23
Q

where are Sertoli cells more concentrated in the tubules

A

near the edge of the circle

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24
Q

what are leydig cells characterised by

A

white dots in the cytoplasm

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25
what are the white dots in the cytoplasm of leydig cells important for?
steroid production
26
first steps of _____ synthesis occur in leydig cells
steroid
27
what do myoid cells do?
contract and move the sperm from the lumen as they cant swim yet
28
biosynthesis of testosterone is mainly in _____ cells
leydig
29
what is testosterone converted into?
dihydrotestosterone
30
what enzyme converts testosterone into dihydrotestosterone?
5a- reductase
31
why is the conversion of testosterone into dihydrotestosterone important?
DHT is a more active androgen than testosterone
32
what does binding of steroidal ligand to cells with receptors on do?
produces a complex with the receptor which then acts on DNA | this alters the repertoire of genes being expressed by target cells and alters RNA production
33
the way the steroids interacts with the DNA defines them as....
transcription factors
34
what are androgens defined as?
compounds that interact with the Androgen receptors and effects them- not a particular structure
35
what cells in the male reproductive system react to androgens? why?
ALL | because they all express AR receptors
36
why is androgen binding needed in all cells?
to fulfil their rolls in sperm production, transport and activation genes need to be activated to trigger processes
37
where else are androgen receptors found?
where secondary sexual characteristics are found- facial hair male baldness increased bone density
38
what are responsible for the development of secondary sexual characteristics?
androgens
39
the ______ control sex steroid production
gonadotrophins
40
explain the HPG axis in males.
GnRH in hypothalamus and is - transported to anterior pituitary via a blood vessel (almost the same as in female) Pituitary produces LH and FSH- govern the production of steroid hormones in the testes
41
pulse ______ of GnRH controls sex hormone production in females
frequency
42
in males GnRH is pulsating how?
at a fixed rate
43
the fixed rate of pulsation in males means?
there's constant levels of LH and FSH
44
what do the sex hormones do in relation to the sperm?
primes cellular environment to help maturation of sperm
45
gonadotrophins need receptors where?
at the cell surface
46
TF: polypeptide hormones dont need receptors at the cell surface? why
false- they need them | as they're water soluble macromolecules
47
where are FSH receptors expressed in males?
Sertoli cells
48
where are LH receptors expressed in males?
leydig cells
49
what cells produce androgen binding protein?
Sertoli cells
50
what is the function of androgen binding protein?
bind steroids as they aren't water soluble | released as a complex
51
where does the steroid ABP complex travel from the Sertoli cell?
to the accessory glands
52
when ABP binds T and DHT what does it do?
concentrates them in the luminal fluid of the seminiferous tubules and downstream regions of the male tract
53
what does the concentration of T and DHT by ABP in the luminal fluid of the seminiferous tubules stimulate?
o spermatogenesis in the seminiferous tubules, sperm maturation in the epididymis accessory gland secretions myoid cell contractile activity to propel sperm along the tract
54
gonadotrophins are _______.
polypeptides
55
in male feedback from the gonadotrophins are purely ______
negative
56
feedback by testosterone is at the level of the.....
anterior pituitary and the hypothalamus
57
what in females stimulates positive feedback?
oestrogen at a specific time of the cycle
58
how does the spem move in the sinoli lumen?
from the outside to the apical/ inner surface of the sinoli lumen
59
in the time the sperm moves from the outside to the inside of the sinoli lumen, what happens?
it undergoes 2 divisions | meiosis
60
at what point do spem cells acquire the characteristics of sperm cells?
after the second meiosis division
61
the sperm exit _____ first into the lumen
tail
62
the maturation of the sperm is ______ dependent
androgen
63
sperimogenesis refers to the stages ______ meiosis
POST
64
spermatogenesis refers to?
the whole process of sperm development
65
TF: when the mature spermatozoa are released into the lumen, they are motile
FALSE
66
when do sperm get the ability to swim?
in the epididymis (DHT dependent) with further activation in the female tract
67
volume of ejaculate?
1.5-5 ml
68
sperm count per ml
40-250 million
69
sperm motility 1h after ejaculation
70%
70
sperm motility 3h after ejaculation
60%
71
why do we want a low leukocyte count in the ejaculate?
reports inflammation
72
why is ejaculate fructose concentration important?
key metabolic substrate for sperm motility
73
fructose conc in the ejaculate?
15-600mg/100ml
74
epidymis and ductus deferens makes up ___% of the ejaculate
5
75
prostatic secretions make up ___% of the ejaculate volume?
13-33
76
seminal vesucle secretions make up ___% of the ejaculate volume
46-80
77
bulbourethral gland secretion makes up ____% of the ejaculate
5
78
what happens in erection
erectile tissue [corpus cavernosum and corpus spongiosum] becomes engorged with blood, arterioles dilated as a result of parasympathetic nervous system activity
79
erection is _____ dependent
nitric oxide
80
emission and ejaculation are controlled by the ______ nervous system
sympathetic
81
pathological causes of erectile dysfunction?
psychogenic neurogenics vascular endocrine
82
iatrogenic causes of erectile dysfunction?
drugs: SSRis antihypertensives: BBs Calcium agonist
83
management of erectile dysfunction?
PGE1- alprostadil | PDE5 inhibitors: sildenafil
84
how do PDE5 inhibitors work? sildenafil
inhibit breakdown of cGMP, maintain erectile function
85
prostate cancer is the ____ cause of cancer death after _____
second | lung
86
risk of prostate cancer in men is?
1 in 6
87
risk factors of prostate cancer
age ethnicity family history
88
can prostate cancer be cured? how | consequences
yes surgically but gives impaired reproductive function
89
symptoms of prostate cancer
Urgent and frequent urination Nocturnal enuresis (involuntary urination) Difficulty starting or emptying the bladder Urine flow weak, interrupted or difficult to control Back or pelvic pain PSA
90
treatment of prostate cancer depends on?
if the cancer is steroid receptor dependent
91
treatment options?
GnRH agonists and antagonists androgen antagonist 5-a-reductase inhibitors
92
how would a GnRH agonist or antagonist work
antagonist: will block it all agonists: high levels make the receptor down regulate
93
androgen antagonist example | what does it depend on?
cyproterone acetate | as long as the tumour retains the androgen dependency- can become independent
94
TF: the prostate tumour is always androgen dependent
FALSE can become independent
95
examples of 5-a- reductase inhibitors | what does it block
Dutasteride Finasteride blocks DST
96
TF: prostate cancer is slow growing
it can be
97
how can exogenous testosterone be used as contraception?
high levels will decrease LH and FSH which will decrease sperm production
98
what is needed to completely inhibit sperm production?
VERY high dose exogenous testosterone
99
how does depo-provers plus testosterone provide contraception? what is it?
 Combination of progestin with testosterone  Progesterone gives you negative feedback.  Exogenous testosterone- maintain circulating testosterone

Patient (19 decks)

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